PUBLIC AUCTION 23
22 OCTOBER ET 22 OCTOBER 2011
David Delhaye sprl · Rue de l'ancien château, 28 · B-7712 Herseaux · Belgium
E-mail : info@daviddelhaye.com · T: +32 (0)56 91 16 15   F: +32 (0)56 91 16 16   Fax et tél: +32(0)223 36 76
I undersigned being at least 18 years of age, agree to abide by all previously stated stipulations and to purchase all the lots for which I have made an offer.
Number of customer :
 
 
Philatelic references (new customer) :
 
First name / Last name :
 
Address :
 
 
Tél. :
 
 
Fax :
 
E-mail :
 
 

Amount not to be exceeded :
 

 To send the lots to the above mentioned address
 The take away of the lots in the store
Client's signature :
 
(Mandatory)  
N° LOT OFFRE
Prière d'écrire très lisiblement
   
   
   
   
   
   
   
   
   
   
KAVEL Nr BOD
Gelieve zeer duideluik te schrijven
   
   
   
   
   
   
   
   
   
   
LOT Nr. BID
Please write clearly
   
   
   
   
   
   
   
   
   
   
   I wish to pay by credit card (+2% expenses) :
Number of your credit card :
-
-
-
    CVV code :
    Expiry date :
/
Signature :